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Description Do you have medical coding experience? Are you looking for a virtual position that allows the flexibility of working at home? Humana is hiring a Medical Coding Auditor. In this ..
Description The Behavioral Health Clinical Advisor (Care Manager, Telephonic Behavior Health 2) will audit CPT (Current Procedural Terminology) codes to ensure correct billing under TOM (TRICARE Operations Manual) policies in accordance ..
Description The Senior Claims Process & Policy Professional processes new insurance policies, modifications to existing policies, and claims forms. The Senior Claims Process & Policy Professional work assignments involve moderately complex ..
Description The Compliance Nurse 2 reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations and to prevent and detect fraud, waste, and abuse. The Compliance Nurse ..
... Information Humana Inpatient Medical Coding Auditor-Remote/Virtual in US in Tampa Florida ... Florida Description The Medical Coding Auditor extracts clinical information from a ... patient records. The Medical Coding..
Description Responsibilities The Associate Director for ACD Audit , at the director of the Director of Payment Integrity, will create and implement process improvement plans focused on the beneficiary and provider ..
Description The Nurse Auditor 2 performs clinical audit/validation processes ... support optimal reimbursement. The Nurse Auditor 2 work assignments are varied ... is looking for a Nurse Auditor 2 Professional..
Description The Medical Coding Auditor reviews medical records to verify coding (ICD-10 CM/PCS). The Medical Coding Auditor work assignments are varied and frequently require interpretation and independent determination of the appropriate ..
Job Information Humana Health Services Compliance Manager - Remote FL in Tampa Florida Description The Manager, Compliance (UM) conducts and summarizes compliance audits. The Manager, Compliance (UM) works within specific guidelines ..
Job Information Humana Medicare Enrollment Representative 2 - Remote in Tampa Florida Description The Enrollment Representative 2 processes applications from members, enrolls them on company platforms, and transmits enrollment to Center ..
... Information Humana Inpatient Medical Coding Auditor (MSDRG/ APDRG)-Remote/Virtual in US in ... Florida Description The Medical Coding Auditor extracts clinical information from a ... patient records. The Medical Coding..
Job Information Humana Senior Compliance Nurse - Remote FL in Tampa Florida Description The Senior Compliance Nurse reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations ..
Description The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM and PCS) to patient records. The Medical ..
Outpatient Risk Coder – National This position reports to the Manager of Risk Adjustment Coding. As a member of the Risk Adjustment team, the Outpatient Risk Coder works remotely in collaboration ..
Description The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation, and billing for services rendered, is complete, compliant and accurate to support optimal reimbursement. The Nurse ..
Description The Payment Integrity Professional 2 uses technology and data mining, detects anomalies in data to identify and collect overpayment of claims. Contributes to the investigations of fraud waste and our ..
Description The Process Improvement Professional 2 analyzes, and measures the effectiveness of existing business processes and develops sustainable, repeatable and quantifiable business process improvements. The Process Improvement Professional 2 work assignments ..
... Information Humana Outpatient Medical Coding Auditor-Remote/Virtual in US in Tampa Florida ... Florida Description The Medical Coding Auditor extracts clinical information from a ... patient records. The Medical Coding..
Description The Fraud Investigation Technician 2 conducts investigations of allegations of fraudulent and abusive practices. The Fraud Investigation Technician 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. ..